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If I reflect on the past decade or so which I have spent in the field of public health, there are a few things which stand out for me; 1) the politicisation or controversial nature of women’s health and young people’s health (including adolescent health), 2) the struggle it has been to begin to make shifts and note progress towards the health of women and young people, 3) the fragility of investments and programming and, 4) despite all the pomp and show, the empty promises and commitments around sexual and reproductive health by the majority of Governments worldwide.

An unfortunately classic example of this in our times/ or in our generation is that of the United Nations Population Fund (UNFPA). In 2017 under the Trump administration, the United States Agency for International Development (USAID) one of the fourth largest contributors, stated that UNFPA will not receive an allocated/ committed $32.5 million. It is interesting to learn that previously, both the Reagan and Bush administrations withheld funding to UNFPA as well. To take us into the ‘Decade of Action’, to ‘Achieve the Sustainable Development Goals’, the United Kingdom (UK) Government a few weeks ago cut UNFPA’s funding by 85% to $32 million instead of the committed $218 million.

This has all happened during a period of endless discussions, speeches among Governments, civil society and women and girls themselves during the renewal of the International Conference on Population and Development (ICPD25) and Beijing 25 and as I said the ‘Decade of so-called action’. When we reach 2030 and reflect on the progress or rather lack of it made towards attaining the SDGs we shouldn’t be shocked at why we haven’t ‘achieved’ anything.

Funding cuts have long been on the horizon, it has never been a sustainable scenario and it is the way the world will turn as we move through the motions of the pandemic. I am also of the school of thought that our African Governments for example squander resources and we don’t even need to be aid dependent. The stark reality, however, is that in most countries I have worked or lived in, health systems are kept up by aid (up-to 90%) so are civil society organizations (CSOs) and the quick pull-out of funders means that the little health services which were being provided is now highly likely to be non-existent. Several CSOs are struggling already, many are set to shut their doors leaving the largest accountability gap in history on women’s and youth health issues.

The depressing observation and conclusion I have come to, is that while the words are uttered,  ‘Women and girls/ adolescents lives matter’, the global community is taking steps in the opposite direction. As the saying goes, ‘Actions speak louder than words.’

It has taken us so long to get to a point, where we started to dent the burden of maternal deaths, HIV, programming to respond to the gender based violence epidemic, the inclusion of young people in policy spaces. We have already lost so much due to the COVID-19 pandemic, the biggest blow will be or is already the loss of sexual and reproductive health and rights.

The wheel is turning or the vehicle is now in reverse, there is less investment, there is less use of certain terminology, there is less programming on certain issues, there are fewer supportive stakeholders.  The eminent regress and doomsday for women and adolescent health issues has begun. The most bizarre is that these issues are never considered within the frame and lens of health, but are instead at the centre of religious/ cultural contention and for politicians to score more political support.

Again, I ask, why are we playing with human lives, specifically those of women and youth?

ABOUT THE AUTHOR:
Dr Shakira Choonara is an award-winning independent public health practitioner, and pens #ThoughtSpace with a touch of inspiration, critical thinking, and creativity

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May 19, 2021